Osteosarcoma

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Researchers work to save limbs as well as lives

Osteosarcoma is a cancer that grows from bone cells. While many different cancers end up spreading to the bone by traveling there from other parts of the body, osteosarcoma is a primary bone cancer, which means it begins in the bone. It causes malignant tumors which weaken the bone. It can also metastasize, spreading elsewhere in the body.

Ninety-percent of all osteosarcomas are a subtype known as conventional central high-grade, although there are many other kinds of osteosarcomas. Subtypes include telangiectatic, small cell, secondary, surface low-grade, and conventional central low-grade.

Quick facts

Osteosarcoma is the most common primary bone cancer.

Because of the rapid cell development during growth spurts, osteosarcoma is typically found in teenagers and young adults, although it can occur at any age.

The disease is slightly more common in males.

The most common sites are the arms or legs, particularly around the knee and shoulder, but any bone can be affected.

Three-fourths of patients diagnosed with non-metastatic osteosarcoma are free of cancer 5 years after diagnosis.

Symptoms

There are no particular symptoms of osteosarcoma, but sometimes medical attention is drawn to the area after the patient experiences:

pain in arms when lifting,

pain in legs when weight-bearing,

swelling, with or without accompanying pain,

a fracture caused by only a slight amount of force.

Diagnosis

There are several tests used to determine the presence of a tumor and find out more about it.

X ray: An image of the bones captured using low amounts of radiation, an X ray is usually the first and best method to screen for this disease.

MRI: A picture of the inside of the body created using magnetic fields and radio waves, this test gives a better view of the tumor and its relationship to surrounding body parts.

Bone scans, positron emission tomography (PET) scans, and blood tests might also be used to aid in the diagnosis.

Biopsy: Finally, doctors take a biopsy of the tumor using a needle or a small incision. This tissue sample is taken to confirm the presence of tumor cells under a microscope before treatment planning begins.

The location of the tumor is often mentioned in the description of an osteosarcoma.

Central means a tumor is located in the middle of the bone.

Surface means a tumor is located on the bone’s outer surface.

Stages

Looking at the biopsy allows doctors to predict how fast the tumor will grow and whether it will spread to the rest of the body. In order to decide on the best course of treatment, doctors review all the test results and evaluate an individual’s cancer in a process known as staging.

As part of the staging process, osteosarcomas are sorted into one of two different grades based on their growth rate.

Low-grade: Slow-growing types of bone sarcomas in this category include surface low-grade and conventional central low-grade.

High-grade: Fast-growing types of osteosarcomas in this category include conventional central high-grade, telangiectatic, small-cell, and secondary-induced bone sarcomas. Most osteosarcomas in young people are high-grade.

The disease is also put in categories based on whether or not it has spread outside its original location.

Localized means the osteosarcoma is only visible in the bone it first grew in and the neighboring tissues. If all the visible tumor can be removed with surgery, it is known as a resectable cancer. If it can only be partially removed by surgery, it is labeled a non-resectable cancer.

Metastatic means the osteosarcoma has traveled from the bone and spread into other parts of the body, such as the lungs or internal organs.

Treatment

The treatment for osteosarcomas usually corresponds with the grade of the disease.

Low-grade

Surgery is performed to remove the tumor immediately after diagnosis. The surgery includes reconstruction using various bone grafts, prosthetic implants, or a combination.

High-grade

Chemotherapy is administered for several months after diagnosis, both to shrink the tumor and to stop the growth of any microscopic tumor cells that might be traveling undetected through the body.

Surgery is then performed to remove the tumor. Amputation of the limb affected by the tumor might be required. Reconstruction of the limb will take place after the tumor’s removal.

Chemotherapy is then repeated a second time after the patient recovers from surgery to make sure any undetectable tumor cells in the bloodstream are destroyed

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Our researchers are top in the nation

The University of Minnesota is a national and international leader in basic science, clinical research, and the development of advances in the treatment of bone and soft tissue tumors. The sarcoma program at the Masonic Cancer Center, University of Minnesota is a collaboration of bone and soft tissue cancer specialists and researchers. It ranks as one of the top sarcoma research and treatment programs in the nation.

Children’s Cancer Research Fund’s relationship with the University of Minnesota supports the work of a multidisciplinary team of physicians who see a high volume of patients with sarcoma. This translates into an unparalleled depth of experience and coordinated advances in laboratory work, clinical research and education. Our goal is to achieve optimal outcomes.

Pilot work for a four-year osteosarcoma study led by Logan Spector, PhD, Associate Professor, Department of Pediatrics was partially funded by the Children’s Cancer Research Fund, and led to a $1.7 million National Cancer Institute grant. This research is evaluating the potential link between genes that trigger bone growth and osteosarcoma in 500 patients. This is the largest epidemiological study ever attempted to investigate the causes of osteosarcoma.

For more on the latest research carried out by our partners, visit our Sarcomas Research page.